Understanding The Facts

If you’re of childbearing age or recently pregnant, you may be wondering about an ectopic or tubal pregnancy, a condition that can occur without warning in the first trimester of pregnancy. Find out the risk factors and symptoms of an ectopic pregnancy.

An ectopic pregnancy is any pregnancy that occurs outside of the uterus, according to Dr. Saul Weinreb, a board-certified OB-GYN in private practice with White Square Obstetrics and Gynecology in Baltimore and a woman's health expert on JustAnswer.com. Although the most common place for an ectopic pregnancy to occur is in the fallopian tubes, it can also occur within the abdominal cavity, on the ovary, in the cervix or in the muscle of the uterus.

Risk factors for ectopic pregnancy

Weinreb notes that any condition that disrupts the integrity of the fallopian tube — such as prior fallopian tubal surgery, a prior tubal pregnancy or a history of pelvic inflammatory disease — can be a risk factor for developing an ectopic pregnancy. Other possible factors include use of an intrauterine contraceptive device, smoking, multiple sexual partners and a history of infertility.

Symptoms of an ectopic pregnancy

"The most common symptoms of an ectopic pregnancy are vaginal bleeding and abdominal or pelvic pain," says Weinreb. "When an ectopic pregnancy grows within the fallopian tube, it may rupture and cause significant abdominal hemorrhage; if left untreated, this bleeding could lead to death."

Diagnosing an ectopic pregnancy

If you're pregnant (or think you might be) and experience these symptoms, says Weinreb, your doctor can generally diagnose the presence of an ectopic pregnancy using a transvaginal ultrasound — in which the doctor uses an ultrasound probe in the vagina to look at the uterus, tubes and ovaries. If a woman's ultrasound findings do not indicate an ectopic pregnancy, her doctor may recommend that she have blood drawn every two days and be monitored closely. Occasionally, a woman may be advised to undergo a laparoscopy to evaluate her abdomen and pelvis surgically for evidence of an ectopic pregnancy.

Treatment for an ectopic pregnancy

"The definitive treatment for an ectopic pregnancy is surgical removal of the pregnancy; however, many women can be safely managed with medical therapy and do not require surgery," says Weinreb. He notes that the exact treatment for the ectopic pregnancy depends on several factors related to a woman's general health, the level of pregnancy hormone in her blood, and the size and location of the ectopic pregnancy. "Discuss the risks and benefits of the various treatments with her doctor to decide which treatment is best for you," he advises.

Preventative measures

Weinreb is quick to point out that, ultimately, a woman who is attempting to get pregnant naturally cannot control where her resulting pregnancy will implant. An important preventable risk factor for ectopic pregnancy, however, is pelvic infection — specifically, the STD chlamydia, which causes scarring in the fallopian tube. "By practicing safe sex, which is a good idea for many reasons, one can prevent this risk factor," says Weinreb.

Unfortunately, a woman with a history of ectopic pregnancy is at increased risk for developing another. Weinreb suggests that she consult her doctor as soon as she discovers she's pregnant; she may need an early ultrasound to confirm that her pregnancy is located safely in the uterus.